Fremitus in Respiratory Diseases

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Questions and Answers

What is the typical outcome of fremitus assessment when the lung becomes consolidated with inflammatory exudate?

Unchanged fremitus

Reduced intensity

Absent fremitus

Increased intensity (correct)

Why is fremitus absent in consolidated lung tissue that is not in communication with patent airways?

Because the speech is not transmitted (correct)

Because the patient is obese

Because the consolidated tissue is too dense

Because the patient has asthma

In which patients is fremitus typically reduced?

Those with pleural effusion

Those with pneumonia

Those with emphysema

Those who are obese or overly muscular (correct)

What is the effect of hyperinflation on fremitus?

Decreases the intensity Signup and view all the answers

What is the purpose of having the patient repeat the word 'ninety-nine' during fremitus assessment?

To assess speech transmission Signup and view all the answers

Why is it important to palpate the corresponding areas on both sides of the chest during fremitus assessment?

To compare the intensity of fremitus Signup and view all the answers

What is the primary goal of assessing tactile fremitus?

To identify areas of lung consolidation Signup and view all the answers

What is the reason for reduced fremitus in patients with excess muscle mass?

Impaired speech transmission Signup and view all the answers

Which of the following conditions is most likely to result in decreased intensity of fremitus?

Pleural effusion Signup and view all the answers

During fremitus assessment, what is the purpose of using the palmar or ulnar aspect of the hand?

To increase sensitivity to vibrations Signup and view all the answers

In which of the following conditions would you expect to find increased intensity of fremitus?

Pneumonia Signup and view all the answers

What is the reason for palpating corresponding areas on both sides of the chest during fremitus assessment?

To assess chest wall symmetry Signup and view all the answers

What is the primary reason for the absence of fremitus in consolidated lung tissue?

The consolidated tissue is not in communication with patent airways Signup and view all the answers

A patient has a pneumothorax in the left lung. What would you expect to find during a fremitus assessment?

Decreased intensity of fremitus on the left side Signup and view all the answers

In which condition would you expect to find increased intensity of fremitus, but only on the right side?

Unilateral pneumonia on the right side Signup and view all the answers

What is the purpose of using the ulnar aspect of the hand during fremitus assessment?

To provide a more focused point of palpation Signup and view all the answers

What is the primary difference between palpating the anterior and lateral portions of the thorax during fremitus assessment?

The anterior portion is more accessible to the examiner Signup and view all the answers

Why is it important to assess fremitus in multiple areas of the thorax?

To compare the intensity of fremitus between the left and right sides Signup and view all the answers

Study Notes

Lung Consolidation and Fremitus

Increased fremitus indicates lung consolidation, typically seen in pneumonia where lung tissue is filled with inflammatory exudate.
Absence of fremitus occurs when consolidated lung tissue is not connected to open airways, preventing speech transmission.
Fremitus intensity can be diminished in patients with higher body mass or significant muscle mass.

Decreased Fremitus Causes

Decreased fremitus occurs when fluid (pleural effusion) or air (pneumothorax) accumulates in the pleural space.
Conditions causing hyperinflation, such as asthma and emphysema, also lead to reduced fremitus due to decreased lung tissue density.

Assessment of Tactile Fremitus

Tactile fremitus is assessed by having the patient repeat "ninety-nine" while a respiratory therapist (RT) palpates the chest.
Palpation involves the anterior, lateral, and posterior thoracic regions using the palmar aspect of the fingers or the ulnar side of the hand.
If using one hand, it should be transitioned from one side of the chest to the corresponding area on the opposite side for a comparative assessment.

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Description

This quiz tests your understanding of fremitus, a vital sign used in physical examination to assess the lungs. It covers the changes in fremitus intensity in various respiratory conditions, such as pneumonia and pleural effusion. Learn how to interpret fremitus in different patients, including those who are obese or muscular.